AgNOR analysis of atypical ductal hyperplasia and intraductal carcinoma ofthe breast

OBJECTIVE: To determine the diagnostic and prognostic value of argyrophilic nucleolar organizer regions (AgNORs) in atypical ductal hyperplasia (ADH), ductal carcinoma in situ (DCIS) and microinvasive ductal carcinoma (MDCA) of the breast. STUDY DESIGN: Image analysis of histologic sections from biopsies of 46 bre ast ADH and DCIS and 28 cases of MDCA. Determination of morphometric featur es of cell nuclei and nucleolar organizer regions by using AMBA software sy stem. Data were compared with the estrogen receptor/progesterone receptor ( ER/PR) content as well as with the growth fraction, determined immuno-histo chemically. RESULTS: AgNOR number and fetal AgNOR area increased from ADH to DCIS. The highest values were recorded in cases of DCIS with microinvasion. Differenc es between ADH and intraductal or microinvasive ductal carcinoma were stati stically significant. Within the group of intraductal carcinomas, the lowes t values were measured in the solid type and highest values in the comedo t ype. A correlation was found between AgNOR features and growth fraction but not between these features and ER/PR status. CONCLUSION: Selected AgNOR features are relevant for differentiation betwee n ADH and DCIS as well as between low and high grade DCIS and microinvasive ductal carcinoma. Therefore, objective and reproducible data obtained by A gNOR analysis may allow better evaluation oft he prognostic significance of these lesions.